The TFOS International Workshop on Contact Lens Discomfort: Report of the Management and Therapy Subcommittee

Papas, Eric; Ciolino, Joseph B.; Jacobs, Deborah S.; MILLER, WILLIAM; Pult, Heiko; Şahin, Afsun; Srinivasan, Sruthi; Tauber, Joseph; Wolffsohn, James S.; Nelson, J. Daniel

doi:10.1167/iovs.13-13166

Cited by 68 publications

(53 citation statements)

References 223 publications

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“…Clinicians can manage contact lens‐related dryness through choice of lens material, lens care and rewetting systems, and management of environmental factors . Contact lens wearers may also require additional management; the report of the TFOS (Tear Film & Ocular Surface Society) International Workshop is available to download, and describes the causes and corresponding management strategies of contact lens‐related discomfort …”

Section: Management Of Digital Eye Strainmentioning

confidence: 99%

Management of digital eye strain

Coles-Brennan

Sulley

Young

2019

Clinical and Experimental Optometry

169

133

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Digital eye strain, an emerging public health issue, is a condition characterised by visual disturbance and/or ocular discomfort related to the use of digital devices and resulting from a range of stresses on the ocular environment. This review aims to provide an overview of the extensive literature on digital eye strain research with particular reference to the clinical management of symptoms. As many as 90 per cent of digital device users experience symptoms of digital eye strain. Many studies suggest that the following factors are associated with digital eye strain: uncorrected refractive error (including presbyopia), accommodative and vergence anomalies, altered blinking pattern (reduced rate and incomplete blinking), excessive exposure to intense light, closer working distance, and smaller font size. Since a symptom may be caused by one or more factors, a holistic approach should be adopted. The following management strategies have been suggested: (i) appropriate correction of refractive error, including astigmatism and presbyopia; (ii) management of vergence anomalies, with the aim of inducing or leaving a small amount of heterophoria (~1.5 Exo); (iii) blinking exercise/training to maintain normal blinking pattern; (iv) use of lubricating eye drops (artificial tears) to help alleviate dry eye-related symptoms; (v) contact lenses with enhanced comfort, particularly at end-of-day and in challenging environments; (vi) prescription of colour filters in all vision correction options, especially blue light-absorbing filters; and (vii) management of accommodative anomalies. Prevention is the main strategy for management of digital eye strain, which involves: (i) ensuring an ergonomic work environment and practice (through patient education and the implementation of ergonomic workplace policies); and (ii) visual examination and eye care to treat visual disorders. Special consideration is needed for people at a high risk of digital eye strain, such as computer workers and contact lens wearers.

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Section: Management Of Digital Eye Strainmentioning

confidence: 99%

Management of digital eye strain

Coles-Brennan

Sulley

Young

2019

Clinical and Experimental Optometry

169

133

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“…ССГ наблюдается у большинства пациентов, которые носят контактные линзы. Часто именно из-за развития ССГ пациенты вынуждены отказываться от ношения контактных линз [7]. В настоящее время ССГ регистрируется у детей и подростков.…”

Section: актуальность проблемыunclassified

Dry Eye Syndrome in General Medical Practice

Gorenkov¹,

Ryabtseva²,

Agafonov³

et al. 2019

EPh

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“…In contact lens wearers, reversible punctal occlusion can increase wearing times and reduce symptoms in people experiencing soft lens discomfort . Occluding both the superior and inferior puncta is likely to be of more benefit than occluding only the lower punctum . However, punctal occlusion should not be undertaken without some caution.…”

Section: Optimising Tear Film and Ocular Surface Health For Contact Lmentioning

confidence: 99%

Tear film evaluation and management in soft contact lens wear: a systematic approach

Downie

Craig

2017

Clinical and Experimental Optometry

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The human tear film is a highly ordered structure consisting of a thin layer of lipid on the surface and a thicker aqueous-mucin phase, which increases in mucin concentration toward the corneal epithelial cell layer. The health of the tear film and ocular surface influences the likelihood of being able to achieve successful contact lens wear. Contact lens discomfort and dryness are the most frequent reasons why contact lens wearers experience reduced wearing times, which can eventually lead to contact lens discontinuation. Comprehensive clinical assessment of tear film integrity and ocular surface health is therefore essential prior to commencing contact lens wear, to enable the ocular surface environment to be optimised to support lens wear. These parameters should also be evaluated over the course of contact lens wear, in order to identify any aspects requiring clinical management and ensure maintenance of optimal lens-wearing conditions. This review summarises current knowledge relating to the effects of soft contact lens wear on the tear film and ocular surface. It also provides a systematic approach to evaluating tear film and ocular surface integrity, in order to guide the clinical management of tear film anomalies with respect to contact lens wear.Key words: conjunctiva, contact lenses, cornea, dry eye, tearsThe tear film is a complex, precisely ordered fluid structure comprising a thin outer layer of lipid and a thicker underlying aqueous-mucin phase, with increasing mucin concentration toward the corneal epithelial cell layer. A thin layer of membrane-bound mucin, glycocalyx, imparts hydrophilicity to the hydrophobic corneal surface.1 In excess of 1,000 proteins or fractions of proteins have been identified within the human tear film.2,3 The tear fluid also contains a variety of regulated inflammatory mediators, including by-products of arachidonic acid metabolism, the complement cascade, cytokines and components derived from the ocular microbiome. 3,4The integrity of the tear film can strongly influence the likelihood of achieving successful contact lens wear. Contact lens discomfort and dryness are the most frequent reasons why contact lens wearers experience reduced wearing times, which can eventually lead to contact lens discontinuation. 5 Comprehensive clinical assessment of tear film quality and quantity, and ocular surface health are therefore essential both prior to commencing contact lens wear, to enable the ocular surface environment to be optimised to support lens wear, and over the course of lens wear, to identify any aspects requiring clinical attention to maintain optimal lens-wearing conditions. This review summarises current knowledge relating to the effects of soft contact lens wear on tear film composition, and outlines an approach to evaluating tear film and ocular surface integrity, to guide the clinical management of tear film anomalies with respect to contact lens wear. ASSESSING THE TEAR FILM AND OCULAR SURFACE IN CONTACT LENS WEAR: A SYSTEMATIC APPROACHUsing techniques such as in...

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The TFOS International Workshop on Contact Lens Discomfort: Report of the Management and Therapy Subcommittee

Cited by 68 publications

References 223 publications

Management of digital eye strain

Management of digital eye strain

Dry Eye Syndrome in General Medical Practice

Tear film evaluation and management in soft contact lens wear: a systematic approach

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